CCMA point of care testing and lab safety practice questions, with every answer explained

1. Bone marrow examination
2. Complete bacterial culture with sensitivity
3. Tissue biopsy analysis
4. Rapid strep antigen test

Answer: D. Many rapid antigen tests, urine reagent strips, urine hCG, capillary glucose, and fecal occult blood tests are waived. Cultures with sensitivity, bone marrow studies, and tissue analysis are moderate- or high-complexity tests performed in laboratories certified under CLIA for moderate- or high-complexity testing.

Why not A: Bone marrow examination is high complexity.

Why not B: Culture and sensitivity testing is not a waived office procedure.

Why not C: Tissue analysis requires a pathology laboratory.

Exam tactic: Waived examples: rapid strep, urine dip, urine hCG, fingerstick glucose, FOBT.

1. Only once, when the meter is first purchased and set up in the office
2. Per the manufacturer's schedule, with each new strip lot, and when results seem wrong
3. Only when a patient calls to complain that a result seemed incorrect
4. Never, because waived meters are exempt from any control testing

Answer: B. Controls confirm that the meter and strips work. They are run at the frequency in the manufacturer's instructions and office policy, plus with each new lot or shipment, after the meter is dropped or serviced, and whenever results are questionable. Results are recorded in a QC log.

Why not A: A single check at purchase cannot detect later problems.

Why not C: Waiting for complaints means inaccurate results may already have been reported.

Why not D: Waived status still requires the manufacturer's QC procedures.

Exam tactic: New lot, dropped meter, weird result, or per schedule: run controls and log them.

1. It is above the normal fasting value of under 100 mg/dL and is reported to the provider
2. It is well within the normal range and requires no action
3. It is dangerously low and indicates hypoglycemia
4. It is the diagnostic threshold for diabetes on a single reading

Answer: A. A normal fasting glucose is generally under 100 mg/dL. Values from 100 to 125 are elevated, and 126 or higher on repeat testing meets a diabetes criterion. The medical assistant reports the value; the provider interprets it.

Why not B: 110 is above the normal fasting cutoff.

Why not C: Hypoglycemia refers to low values, generally under 70 mg/dL.

Why not D: The fasting diabetes threshold is 126 mg/dL on laboratory testing, confirmed by repeat testing; point-of-care meters are not used to diagnose diabetes.

Exam tactic: Fasting: under 100 normal, 100 to 125 elevated, 126+ diabetes range. MA reports, provider interprets.

1. The amount of glucose in the plasma
2. The percentage of blood volume made up of red blood cells
3. The time it takes for blood to clot
4. The number of white blood cells per microliter

Answer: B. The hematocrit is the proportion of whole blood volume occupied by packed red blood cells, expressed as a percentage. Low values suggest anemia; high values can suggest dehydration or polycythemia.

Why not A: Glucose is a chemistry test.

Why not C: Clotting time is measured with coagulation tests.

Why not D: White cell counts are a separate measurement.

Exam tactic: Hematocrit = packed red cells as a percentage of the blood.

1. The number of red blood cells in the specimen
2. The blood glucose level at the moment of collection
3. The patient's cholesterol level after fasting
4. Average blood glucose over roughly the past two to three months

Answer: D. Glucose attaches to hemoglobin over the red cell's lifespan, so A1c reflects average glucose over about 2 to 3 months. It is used to diagnose diabetes and monitor long-term control, and it does not require fasting.

Why not A: Red cell count is part of a CBC.

Why not B: A point-in-time value is a random or fasting glucose.

Why not C: Cholesterol is measured with a lipid panel.

Exam tactic: A1c = the 3-month average. No fasting needed.

1. The patient's medical record
2. The equipment maintenance log
3. The office appointment schedule
4. The Safety Data Sheet (SDS) for that chemical

Answer: D. Under OSHA's Hazard Communication Standard, employers must keep a Safety Data Sheet for each hazardous chemical, accessible to employees. The SDS describes hazards, protective equipment, handling, storage, spill response, and first aid.

Why not A: Patient records do not contain chemical hazard information.

Why not B: Maintenance logs record equipment servicing, not chemical hazards.

Why not C: The schedule is unrelated to chemical safety.

Exam tactic: Chemical question? SDS.

1. A coverslip removed and the slide viewed dry at high light
2. A drop of immersion oil between the slide and the objective, with fine focus only
3. The coarse focus knob turned rapidly toward the slide
4. Water in place of oil to protect the lens

Answer: B. The oil-immersion lens requires immersion oil to reduce light refraction and produce a clear image. Only the fine adjustment is used at this magnification to avoid driving the lens into the slide. The oil is cleaned from the lens with lens paper afterward.

Why not A: The 100x objective does not produce a clear image without oil.

Why not C: Coarse focusing at high power can crack the slide and damage the lens.

Why not D: Water does not have the right optical properties for oil-immersion work.

Exam tactic: 100x = oil + fine focus only.

1. The flag indicates the specimen was hemolyzed and can be ignored
2. The value is above the reference range; the result is routed to the provider per office protocol
3. The patient should be told the diagnosis immediately by the medical assistant
4. The result must be deleted and the test repeated automatically

Answer: B. 'H' flags a value above the laboratory's reference range (and 'L' below). Abnormal and critical results are routed to the provider according to office protocol, with critical values communicated immediately. Interpretation and diagnosis are the provider's role.

Why not A: 'H' means high, not hemolyzed.

Why not C: Diagnosing or interpreting results for the patient is outside the medical assistant's scope.

Why not D: Results are never deleted; the provider decides whether to repeat.

Exam tactic: H/L flags go to the provider. Critical values go immediately.

1. LDL
2. Triglycerides
3. VLDL
4. HDL

Answer: D. High-density lipoprotein (HDL) helps remove cholesterol from the arteries, so higher levels are generally favorable. LDL is often called 'bad' cholesterol because high levels contribute to plaque.

Why not A: LDL is the so-called 'bad' cholesterol.

Why not B: Triglycerides are a type of fat; high levels are unfavorable.

Why not C: VLDL carries triglycerides and is not considered 'good' cholesterol.

Exam tactic: HDL = Healthy (high is good). LDL = Lousy (low is good).

1. Rapid antigen tests can produce false negatives; the provider decides on further testing or treatment
2. The medical assistant should tell the patient it is just a cold
3. A negative rapid test proves the patient does not have influenza
4. The test must have been performed incorrectly and should be repeated until positive

Answer: A. Many rapid antigen tests are highly specific but less sensitive, so a negative result does not rule out infection, especially when community activity is high. The result is reported to the provider, who interprets it with the clinical picture.

Why not B: Diagnosing is outside the medical assistant's scope.

Why not C: A negative rapid test does not rule out influenza.

Why not D: Repeating a test until it matches expectations is not valid practice.

Exam tactic: Rapid antigen negative ≠ ruled out. Report; the provider interprets.